阻塞性睡眠呼吸暂停低通气综合征患者血氧饱和度相关指标分析

Analysis on the related indices of oxygen saturation in obstructive sleep apneahypopnea syndrome patients

摘要:

目的分析阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患者的血氧饱和度相关指标，寻求能够更好地评估OSAHS患者严重程度及相关并发症的指标。方法选取2016年1月～2018年7月在北京大学人民医院耳鼻咽喉科门诊确诊为OSAHS的患者110例，回顾性分析其多导睡眠监测（polysomography ，PSG）结果。依据睡眠呼吸暂停低通气指数（apnea and hypopnea index，AHI）值将OSAHS患者分为轻度（AHI为5~15次/h）、中度（AHI为＞15~30次/h）、重度（AHI＞30次/h）3组，对比3组间血氧饱和度相关指标。将OSAHS患者根据是否合并高血压分为两组，对比其血氧饱和度指标。结果结果显示轻、中、重3组患者间最低血氧饱和度（lowest oxygen saturation，LSaO2）、平均血氧饱和度（average oxygen saturation,ASaO2）、氧减饱和度指数（oxygen desaturation index，ODI）经比较均有统计学差异（P均＜0.05），且与AHI密切相关，其中ODI与AHI相关性最强，呈高度相关（r=0.879），LSaO2与AHI呈强相关（r=0.613），ASaO2与AHI中等相关（r=0.525）。未合并高血压组与合并高血压组间患者LSaO2经比较没有统计学差异（P=0.266），ASaO2和ODI经比较有统计学差异，P值分别为0.035和0.009。结论ODI以及ASaO2是PSG监测中良好的筛查指标，可作为LSaO2的补充，应用于OSAHS的筛查诊断和严重程度分级。同时ODI以及ASaO2能够更好地反应出氧减饱和度事件的持续时间和频率，后者与OSAHS患者并发高血压的发病机制有关。

关键词:阻塞性睡眠呼吸暂停低通气综合征|最低血氧饱和度|平均血氧饱和度|氧减饱和度指数

Abstract:

ObjectiveTo explore better indicators to evaluate the severity and complication of obstructive sleep apnea hypopnea syndrome (OSAHS) by analyzing the related indices of oxygen saturation.MethodsThe polysomography (PSG) data of 110 patients with OSAHS diagnosed in otorhinolaryngology clinic of our hospital were analyzed retrospectively. According to the apnea and hypopnea index (AHI) score, they were divided into three groups, i.e. mild group (AHI 5-15), moderate group（AHI >15-30） and severe group (AHI>30). The related indices of oxygen saturation were compared and analyzed among the three groups. In addition, all the patients were divided into groups with and without hypertension based on their blood pressure, and their related indices of oxygen saturation were also compared.ResultsThe differences among the three groups in the related indices of oxygen saturation including the lowest oxygen saturation (LSaO2), the average oxygen saturation (ASaO2) and oxygen desaturation index (ODI) were all statistically significant (all P<0.05). The abovementioned indices were all closely related to AHI, with strongest intensity of correlation with AHI in ODI (r=0.879) followed by LSaO2 (r=0.613) and ASaO2 (r=0.525) in order. As for the complicated hypertension, the differences between the two groups in ASaO2 (P=0.035) and ODI (P=0.009) were both statistically significant while insignificant in LSaO2 (P=1.252).ConclusionsPerforming well in diagnostic screening and severity evaluation of OSAHS, ASaO2 and ODI can be used as supplements to LSaO2. Furthermore, ASaO2 and ODI can reflect the duration and frequency of oxygen desaturation events, which relates to the pathogenesis of hypertension complicated in OSAHS.

Key words:Obstructive sleep apnea hypopnea syndrome|Lowest oxygen saturation|Average oxygen saturation| Oxygen desaturation index